Professional French horn players in danger of developing noise-induced hearing loss

Sep. 24, 2013 — Professional French horn players may need to seriously consider adopting effective strategies to prevent noise-induced hearing loss (NIHL). A new study published online in the Journal of Occupational and Environmental Hygiene (JOEH) found further evidence that French horn players are one of the most at-risk groups of developing NIHL among professional orchestral musicians.

"Using both conservative and lenient criteria for hearing loss and correcting for age, we found that between 11 percent and 22 percent of the participants showed some form of hearing loss typical of NIHL," said study investigator Ian O'Brien, MPhil, MAudSA, CCP, a doctoral degree candidate at the University of Sydney and a professional French horn player. "Looking at those aged 40 years or younger and also correcting for age, the number of horn players with an apparent hearing loss rose to between 17 percent and 33 percent."

The study, conducted by researchers from the University of Queensland and the University of Sydney at the 2010 annual gathering of the International Horn Society in Brisbane, Australia, examined the hearing of 144 French horn players. The investigators performed audiometric assessments and measured sound levels and hearing thresholds to determine if the horn players were at risk of harmful sound exposure.

O'Brien and his colleagues also administered a questionnaire to investigate the horn players' safety practices and attitudes about hearing conservation.

"We were surprised to find that only 18 percent of participants reported using any form of hearing protection," said lead investigator Wayne Wilson, PhD, MAudSA, CCP, a senior lecturer in audiology at the University of Queensland. "Even within that 18 percent, the use of hearing protection appears to be inadequate with 81 percent of these participants reporting their frequency of use as 'sometimes' and 50 percent reporting they use generic, foam or other inferior forms of protection."

According to the National Institute on Deafness and Other Communication Disorders (NIDCD), when individuals are exposed to loud noise over a long period of time, symptoms of NIHL will increase gradually. The NIDCD recommends preventing NIHL by regularly using hearing protectors such as earplugs or earmuffs. Designed specifically for musicians such as French horn players, these devices are commercially available.

"Our findings also reinforce the need to educate horn players, their mentors and audiologists about the need to protect hearing and how best to achieve this while still enabling musicians to play to the highest level," said O'Brien. "Even mild hearing loss can result in difficulties discriminating pitch, abnormal loudness growth and tinnitus, all of which can affect a musician's ability to perform, subsequently jeopardizing his or her livelihood."

The Bureau of Labor Statistics reports that there have been nearly 125,000 cases of permanent hearing loss in workers since 2004. In addition to hearing loss, exposure to high levels of noise can result in physical and psychological stress, reduced productivity, poor communication, and accidents and injuries caused by a worker's inability to hear warning signals.

According to Torey Nalbone, PhD, CIH, associate professor at the University of Tyler, Texas, and an AIHA noise exposure expert, "Traditionally, we have examined rock and roll artists and their hearing loss, but few think of the hearing loss experienced by symphonic orchestra players. The presence of loss of hearing acuity in the ranges documented in this study demonstrates that orchestral musicians should take a more active role in conserving their hearing."

He adds, "The appropriate use of hearing protection devices can and will reduce the incidence of NIHL. This could be an important attitude and habit to change for these horn players and others in an orchestral setting, especially when they depend on their hearing for a major portion of their success during performances."

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Danger at Home Lurks in Pills, Plants, Chemicals and More

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AppId is over the quota

FRIDAY, June 8 (HealthDay News) -- If you have children or pets, you've probably looked around your house to see what potential hazards you need to lock up or move, like the cleaning products under the sink. But it's easy to overlook something a child might find appealing.

That windshield washer fluid in the garage might look like a big jug of blue fruit drink to a child. Medication that's red and round can look a lot like a candy to a youngster.

No home can be 100 percent safe, but you can take steps to protect your family from the most serious threats in your home.

"You have to anticipate what kids might do," said Rose Ann Soloway, a clinical toxicologist with the National Capital Poison Center in Washington, D.C. "They're smart and fast, and they like to imitate us."

"I compare children getting into medicines and poisons to a young child rolling over for the first time and falling off a bed or couch," Soloway said. "How often do you hear parents say, 'I didn't know he could do that' when a child rolls over for the first time? While it's not possible to be with a child 24 hours a day, it's important that the things that can really hurt them have as many barriers as possible. Keep anything dangerous locked up and out of reach. Children rely on us to provide a safe environment."

So what are the biggest problems that could be lurking in your home?

"The most dangerous are probably medications," said Dr. Jennifer Lowry, a medical toxicologist at Children's Mercy Hospitals and Clinics in Kansas City. "Parents don't always put them away. Grandparents don't always remember that they could be an issue. Their medications may be in pill boxes that are easy to open. And, older adults are on more medications that can be toxic to children."

Soloway said that the medications of greatest concern when taken by those who don't need them are blood pressure and heart medications, as well as narcotic medications to relieve pain. It's also not always children who are an issue with medications. Poison control centers get lots of calls from older adults who've mixed up their medications.

But even pills people might think are safe can be an issue if the dose is large enough.

"Everything can be a poison depending on the dose," said Lowry. People might not be concerned about leaving vitamins accessible, but iron can be extremely toxic, she noted.

Soloway said that personal care products also prompt a lot of calls to poison control centers. "The ones we worry about are those with alcohol in them," she said. "Children can get alcohol poisoning from mouthwash. Children see adults putting it in their mouths, so why wouldn't they? But, they don't get the swish-and-spit part."

Then there are pesticides, which can be dangerous if they're swallowed, breathed in or gotten on the skin. "It's so important to understand that these products are intended to kill an organism," Soloway noted.

Products called hydrocarbons, such as gasoline, kerosene, lighter fluid and lamp oil, are also a concern. Though they generally pass through the digestive system without causing too much damage, they can get into the lungs, causing a serious condition called aspiration pneumonia, if a child swallows one of the products and then vomits it up.

Immediate harm can come from products that can cause chemical burns on contact, including drain openers, toilet bowl cleaners and dishwasher detergent.

But preventing poisonings at home really boils down to common sense, Lowry said. Store cleaning products and other chemicals in their original containers and store them on a high shelf. The same goes for medications -- or, even better, keep them in a locked box. Replace childproof caps tightly after you use a medication.

If you have to use a pesticide or a cleaning product, use them in well-ventilated areas and follow the label instructions. "If a warning is there, pay attention to it," advised Soloway. She also recommended using just the amount of product that you need.

People who have plants in their homes need to know exactly what they are, as some can be irritating and others safe, Lowry said. And without knowing the kind of plant, it's difficult for poison control to help.

She also suggested getting down on your hands and knees and crawling around your house to get the same view your child might have. "That's when you'll see grandma's heart medicine that fell under the couch," Lowry said.

If the worst happens and you or a child has come into contact with a poisonous substance or ingested it, the first thing to do is to call 1-800-222-1222. That's a nationwide number that will link you to a poison control center, which has experts who can judge whether the situation can be handled at home or whether an ER visit is needed.

More information

The U.S. Centers for Disease Control and Prevention has more tips on preventing poisoning.

For more on the risks of poisonings at home, read a companion article on one woman's story.

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